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Who Establishes New Digital health Initiatives

How World Health Organisation wants to strengthen national health systems with digital health? How digital health can tackle challenges in public health? We talk with Clayton Hamilton who leads the eHealth and Innovation portfolio of the WHO European Region.

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Member editorial board ICT&health

Artur Olesch

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Clayton Hamilton: Digital health offers essential solutions to important social and demographic stresses, global inequity and health security issues, both now and in the future.

On the 25th of May 2018, Member States at the seventy-first World Health Assembly supported a proposed resolution for the advancement of global digital health. Why the resolution is important and what does it mean?

The resolution on digital health passed at this year’s World Health Assembly was truly historic in nature as for the first time, the strategic role of digital health in strengthening health systems and achieving Universal Health Coverage (UHC) was recognized. UHC is a recognition by all Member States that people and communities should have access to the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose individuals to financial hardship.

The resolution on digital health was passed unanimously, with many supportive statements also made by Non-Governmental Organizations. It also brought two main deliverables into focus: the development of a global public health strategy on digital health, which I believe is long overdue, and a new mandate for WHO to provide countries with enhanced support in accelerating the adoption of digital technologies as a key component of health systems’ reform.

How eHealth can strengthen health systems and how digital health can tackle challenges in public health?

Today, the potential of digital health in strengthening the operation of national health systems is becoming well-recognized. We see many examples of its use in different countries and contexts to extend the scope, transparency and accessibility of health services and information, improve service delivery and health systems efficiency, facilitate training of the health workforce, and empower patients as part of a movement towards person-centred care.

Digital health is becoming a major facilitator in achieving the public health priorities

However, digital health is also becoming a major facilitator in achieving the public health priorities of the European Regional health policy framework, Health 2020, and the UN 2030 Agenda for Sustainable Development. In fact, digital health is being employed to strengthen public health efforts for improving the health and well-being of populations in a multitude of different ways, but I believe its most powerful potential lies in increasing the capacity of countries to achieve their targets for Universal Health Coverage.

Here digital health is catalysing a change in thinking as to how governments can enable access to healthcare for their citizens, widen the population base capable of accessing the available health services (including reaching marginalized and underserved population groups), improve public health surveillance, and reform processes underpinning the functioning of health systems. It also offers essential solutions to important social and demographic stresses, global inequity and health security issues, both now and in the future.

Digital health could help to deliver affordable, timely, quality healthcare but the progress in digital health adoption is very slow. Why?

It’s important to understand that there is no single underlying cause for the relatively slow progress in national digital health adoption to date. While there is commonality in barriers and enablers for digital health between countries, different social, financial, political and cultural contexts influence the rate at which innovation and sustained change in health systems can be applied. This is coupled with the fact that the systems themselves are highly complex, multi-faceted and specialized entities that demand the highest possible level of quality and availability every day of the year.

There are however a number of contributors to slow progress in digital health adoption which we regularly observe, and countries are working hard to address. These include, an abundance of legacy systems and lack of a coherent integration strategy, obsolete or inadequate regulatory and legislative frameworks, low adoption of standards for digital health, slow recognition of the need for security and privacy, insufficient engagement of the patient in solution design, poor communication in support of change initiatives, low levels of digital literacy in the health workforce, difficulty in obtaining funding and demonstrating the return on investment for digital health, inadequate technical infrastructure and supporting technologies, poor knowledge of appropriate governance for digital health, and geo-political factors often associated to regionalization within countries.

Many of the factors above contribute either directly or indirectly to a failure in establishing a culture of trust for digital health – which is a pivotal factor for success.

To accelerate progress and assist countries in overcoming the above challenges, the Regional Director of the WHO Regional Office for Europe, Dr Zsuzsanna Jakab, has recently established the WHO/Europe Digitalization of Health Systems initiative, the aim of which is to catalyse action and partnerships for accelerating the digitalization of national health systems in Europe. Through the actions proposed under this initiative, it is hoped that digital health will have a greater role in integrating, strengthening and improving the performance of health systems, moving healthcare towards models of prevention rather than treatment (enabling individuals to take a more proactive role in managing their own health) and building trust and credibility within national health ecosystems.